Identifying sex-specific anthropometric measures and thresholds for dysglycemia screening in an HIV-endemic rural South African population

Bibliographic Data

ID19590938
AuthorsAlison Castle (0000-0001-7752-6236, Harvard University, corresponding author), Susanne S Hoeppner (0000-0003-2060-1666, Harvard University), Jennifer Manne-Goehler (0000-0001-9295-0035, Harvard University), Jennifer M Manne-Goehler, Stephen Olivier (0000-0003-3855-5821, Africa Health Research Institute), Itai M Magodoro (0000-0002-3879-6126, Emory University), Urisha Singh (0000-0001-6905-7599, Africa Health Research Institute), Johnathan Edwards (0000-0003-1292-7885, Emory University), Johnathan A Edwards, Frank Tanser (0000-0001-9797-0000, Africa Health Research Institute), Ingrid V Bassett (0000-0001-6920-6080, Harvard University), Emily Wong (0000-0003-4755-5380, University of Alabama at Birmingham), Emily B Wong, Mark J Siedner (0000-0003-3506-842X, Harvard University), on behalf of the Vukuzazi Study Team
EditorsJulia Robinson (0000-0003-0719-3995)
Year2023
Volume3
Issue10
Pagese0001698
Publication date2023-10-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001698
PMID37889883
OpenAlexW4387976129
LanguageEN
References cited38

Valid screening and diagnostic algorithms are needed to achieve 2030 targets proposed by the WHO’s Global Diabetes Compact . We explored anthropometric thresholds to optimally screen and refer individuals for diabetes testing in rural South Africa. We evaluated screening thresholds for waist circumference (WC), body mass index (BMI), and waist-hip ratio (WHR) to detect dysglycemia based on a glycated hemoglobin (HbA1C) ≥6.5% among adults in a population-based study in South Africa using weighted, non-parametric ROC regression analyses. We then assessed the diagnostic validity of traditional obesity thresholds, explored optimal thresholds for this population, and fit models stratified by sex, age, and HIV status. The prevalence of dysglycemia in the total study population (n = 17,846) was 7.7%. WC had greater discriminatory capacity than WHR to detect dysglycemia in men (p-value 81cm) performed well (sensitivity 91%, positive predictive value [PPV] 14.9%), substantially lower thresholds were needed to achieve acceptable sensitivity and PPV among men (traditional >94cm, derived >79.5cm). WC outperforms BMI as an anthropometric screening measure for dysglycemia in rural South Africa. Whereas WC guideline thresholds are appropriate for women, male-derived WC cutoffs performed better at lower thresholds. In this rural South African population, thresholds that maximize specificity and PPV for efficient resource allocation may be preferred

Anthropometry · Body mass index · Diabetes mellitus · Environmental health · Glycated hemoglobin · Population · Receiver operating characteristic · Type 2 diabetes · Waist · Demography · Diabetes and associated disorders · Diabetes, Cardiovascular Risks, and Lipoproteins · HIV-related health complications and treatments · Medicine · Endocrinology · Internal Medicine

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